Immunological Medications for HIV, AIDS, & Transplant Care — NCLEX-PN Review | Chapter 60: Saunders

Immunological Medications for HIV, AIDS, & Transplant Care — NCLEX-PN Review | Chapter 60: Saunders

Chapter 60 of Saunders Comprehensive Review for the NCLEX-PN® Examination (7th Edition) by Linda Anne Silvestri and Angela E. Silvestri delivers a comprehensive review of immune-related pharmacology, focusing on medications for HIV/AIDS management, prevention of transplant rejection, treatment of opportunistic infections, and antibiotic therapy. This chapter equips NCLEX-PN candidates with essential drug mechanisms, side effect profiles, and nursing safety considerations for immune-modulating medications.

Watch the lecture above for a complete immune medication review, then read the detailed breakdown below to reinforce your NCLEX-PN pharmacology knowledge.

Saunders NCLEX-PN Examination Review book cover

HIV/AIDS Antiretroviral Therapy (HAART)

  • NRTIs: abacavir, zidovudine, lamivudine — risks include anemia, lactic acidosis, hepatomegaly.
  • NNRTIs: nevirapine, efavirenz — rash, hepatitis, CNS effects, Stevens-Johnson syndrome.
  • Protease Inhibitors (PIs): atazanavir, ritonavir — GI upset, hyperlipidemia, liver toxicity.
  • Fusion Inhibitor: enfuvirtide — injection site reaction, fatigue, insomnia.
  • Integrase Inhibitor: raltegravir — nausea, fatigue, itching.
  • CCR5 Antagonist: maraviroc — URI, dizziness, hepatotoxicity.

Opportunistic Infection Treatments

  • Pneumocystis jiroveci: trimethoprim-sulfamethoxazole (TMP-SMX).
  • Toxoplasmosis: sulfamethoxazole-trimethoprim.
  • Fungal infections: amphotericin B (nephrotoxicity monitoring), fluconazole.
  • Viral infections: acyclovir, ganciclovir.

Transplant Immunosuppressants

  • Calcineurin Inhibitors: cyclosporine, tacrolimus — nephrotoxicity, hypertension, infection risk.
  • Antimetabolites: azathioprine, mycophenolate — bone marrow suppression, GI side effects.
  • Monoclonal/Polyclonal Antibodies: basiliximab, antithymocyte globulin — infusion reactions, anaphylaxis risk.
  • mTOR Inhibitor: sirolimus — lipid changes, renal injury, thrombocytopenia.

Antibiotics Review

  • Aminoglycosides: ototoxicity, nephrotoxicity — monitor hearing and renal function.
  • Cephalosporins, Fluoroquinolones, Macrolides: GI upset, hypersensitivity reactions.
  • Sulfonamides: hypersensitivity, bone marrow suppression.
  • Tetracyclines: photosensitivity, tooth discoloration — avoid in pregnancy and children.

NCLEX-Priority Nursing Considerations

  • Teach patients that HIV therapy is lifelong and requires strict adherence.
  • Avoid live vaccines while on immunosuppressants.
  • Monitor CBC, LFTs, and renal function for all major immune-related medications.
  • Educate on side effect recognition and when to seek medical attention.

Conclusion

Chapter 60 prepares nurses to administer and monitor medications that modulate immune function, protect against opportunistic infections, and prevent organ transplant rejection. Understanding drug classes, mechanisms, side effects, and nursing precautions ensures both NCLEX success and safe, effective client care.

Subscribe to Last Minute Lecture for more NCLEX-focused lectures and clinical care reviews.

View the complete Saunders Comprehensive Review for the NCLEX-PN® Examination (7th Edition) playlist here: Complete NCLEX-PN Review Playlist

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